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Although the past 20 years have brought great progress, lung cancer remains one of the most common—yet hardest-to-treat—types of cancer. But doctors are hopeful that expanding access to lung cancer screening might lead to an increase in the diagnosis of the disease during its earliest stages, when it can often be cured.
Screening with a low-dose CT (computed tomography) scan may be lifesaving for the approximately 15 million people who have become eligible since 2021, when the U.S. Preventive Services Task Force (USPSTF) expanded the criteria for recommended screening.
This fall, the American Cancer Society (ACS) also weighed in, recommending a low-dose CT scan for anyone who has a significant smoking history (more on the changing guidance below).
And yet, only about 6% of eligible people are getting the screening. “It is important that we try to understand and then remove barriers preventing millions of Americans at risk for lung cancer from getting screened,” says Lynn Tanoue, MD, MBA, director of the Lung Cancer Screening Program at Yale.
A lack of awareness among clinicians that lung cancer screening is available and covered by Medicare and other insurers is a major barrier, Dr. Tanoue adds. “Physicians and other medical providers may simply not know lung cancer screening has been proven to be effective in saving lives,” she says. “National efforts like Lung Cancer Awareness month [in November] and local efforts educating our medical communities are all important in overcoming this.”
Another big obstacle is that many people don’t know they have the option, explains Justin Blasberg, MD, MPH, a Yale Medicine thoracic surgeon. “We could save so many more lives if more people were screened. With significant advances in the field and new therapeutics, there is a possibility of a cure for more patients.”
For some smokers and former smokers, there is also a stigma surrounding screening—they feel they’ll be blamed for a highly addictive habit. “We need to continue to work on getting rid of this stigma,” says Dr. Tanoue. “No one should ever be blamed for having what could be a fatal disease.”
Screening may be especially important for Black men, who are hit harder by lung cancer than any other group; they tend to be diagnosed at younger ages and with a shorter history of smoking, and are more likely to die of the disease than other groups, adds Dr. Tanoue. “Importantly, in the original National Lung Screening Trial, which was a large study proving the benefit of lung cancer screening, Black men not only had an improvement in terms of fewer deaths from lung cancer, they also had an improvement in terms of fewer deaths from all causes, including cardiovascular disease, which suggests even more benefit from the screening,” she says.
If you think you may be at risk for lung cancer, Yale Medicine doctors answered three important questions about screening.
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